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Inflammatory Tumor Microenvironment in Cranial Meningiomas: Clinical Implications and Intraindividual Reproducibility
Johannes Wach1, Tim Lampmann1, Ági Güresir1
1Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany.
Abstract:
The MIB-1 index was demonstrated to be significantly correlated to meningioma recurrence. However, to date, the relationship of the intraindividual course of the MIB-1 index and the growth fraction, respectively, to clinical tumor recurrence has not been demonstrated in cranial WHO grade 1 and 2 meningiomas. In the present paper, we compare the MIB-1 indices of 16 solely surgically treated primary meningiomas and their recurrent tumors regarding the course of the MIB-1 indices, time to recurrence, reproducibility and factors influencing the intraindividual MIB-1 indices. Regression analyses revealed (1) a strong intra-lab reproducibility (r = 0.88) of the MIB-1 index at the second versus the first operation, corresponding to a constant intrinsic growth activity of an individual meningioma, (2) a significant inverse correlation of both primary (r = -0.51) and secondary (r = -0.70) MIB-1 indices to time to recurrence, and (3) male sex, low plasma fibrinogen and diffuse CD68+ macrophage infiltrates contribute to an increase in the MIB-1 index. A strong intraindividual reproducibility of the MIB-1 index and a direct relationship of the MIB-1 index to the time to recurrence were observed. Individual MIB-1 indices might be used for tailored follow-up imaging intervals. Further research on the role of macrophages and inflammatory burden in the regrowth potential of meningiomas are needed.
Insights
The MIB-1 index consistently predicts meningioma recurrence, showing strong intraindividual reproducibility. Higher MIB-1 indices correlate with shorter times to tumor recurrence, suggesting its use in personalized follow-up strategies.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- The MIB-1 index is a known predictor of meningioma recurrence.
- The intraindividual course of the MIB-1 index and its relation to clinical recurrence in cranial WHO grade 1 and 2 meningiomas remain underexplored.
- Understanding MIB-1 index dynamics is crucial for predicting meningioma behavior.
Purpose of the Study:
- To compare MIB-1 indices between primary and recurrent meningiomas.
- To investigate the intraindividual course, reproducibility, and influencing factors of the MIB-1 index.
- To establish the relationship between MIB-1 indices and time to recurrence.
Main Methods:
- Analysis of MIB-1 indices from 16 surgically treated primary and recurrent meningiomas.
- Assessment of intra-lab reproducibility of MIB-1 index measurements.
- Regression analyses to determine correlations between MIB-1 indices, time to recurrence, and clinical factors.
Main Results:
- High intra-lab reproducibility (r=0.88) of the MIB-1 index between serial operations indicates stable intrinsic growth activity.
- Significant inverse correlations were found between primary (r=-0.51) and secondary (r=-0.70) MIB-1 indices and time to recurrence.
- Male sex, low plasma fibrinogen, and diffuse CD68+ macrophage infiltrates were associated with increased MIB-1 indices.
Conclusions:
- The MIB-1 index exhibits strong intraindividual reproducibility and directly correlates with time to meningioma recurrence.
- Individual MIB-1 indices may guide tailored follow-up imaging schedules for meningioma patients.
- Further research is warranted into the role of macrophages and inflammation in meningioma regrowth.
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